Sunday, December 13, 2009

The Incredible Case of Phineas Gage!

Phineas Gage born in 1823 was a regular man who was a foreman on a crew of railroad construction workers who were working on the Berlington Railroad. What they would do on the railroad is insert dynamite into holes in the ground then plug up those holes with sand and light a fuse so the force of the dynamite would go into the boulder and not to the outside. They would do this with a tamping iron which is a long iron rod about three feet in length. One day on September 13th 1848 when Gage was 25 he was working on the Berlington Railroad in Vermont when a spark ignited the gun powder and sent a tamping iron straight through his left cheek bone up through his skull. Surprisingly Gage was able to stand up, walk, and even talk just minutes after the horrific accident. Gage was rushed to the doctor where Dr. John Martin Harlow examined him. Dr. Harlow confirmed that the rod that entered his skull was 3 feet 8 inches in length and 1.25 inches in diameter and it weighed 6 kg. Dr. Harlow did not treat Gage surgically but replaced the parts of his skull that he could with adhesive wrap and put a wet compress on the open part of Gage’s skull. Within a few days of the accident Gage’s brain became infected with a fungus and he went into a semi-comatose state. Gage’s family planned for his death but surprisingly enough Gage came out of his coma and by January 1st 1849 Gage was seemingly as normal as ever. His colleagues and family members soon noticed a difference in Gage’s personality though. His work wouldn’t even let him back on the job. They said he was defiant, disrespectful, and impatient when something conflicted with what he wanted, rude, indecisive etc. He was to his friends “no longer Gage.” Doctors soon found out that the damage done to Gage’s frontal cortex led to social inhibitions which usually led to inappropriate behavior. It’s not certain what Gage did after his accident but eventually in 1859 with his health declining, he went to live with his mother. He died on May 20th 1860 13 years after his accident.

This accident of Phineas Gage was extremely important in the advancement of neurology and also the study of the brain. David Ferrier carried out a physiological study about localization of cerebral functions. Ferrier used Gage’s story as a highlight in his Goulstonian lecture in 1878 and ultimately Gage’s story helped prove Ferriers hypothesis that damage to the prefrontal cortex could result in personality changes. So this story does in fact affect society because it helps us better understand the brain and the functions of the brain. This is good news to us so we can better understand the brain and how it works and what it can really do. We should care so we know what to do the next time something like this happens. We should also care because now we have some insight on how to treat brain injuries such as Gages. Of course this study of science is fairly new and there are still so many questions to be answered. Like how exactly and what exactly does the prefrontal cortex do. Is this the only part of the brain that controls the personality? What else can be changed by altering the brain in ways? At least these are some of my questions. Now that we have better technology and equipment we can discover the answers to some of these questions and some of the questions that arose in the eighteen hundreds when Gage had his accident.


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